Serial high-resolution analysis of blood virome and host cytokines expression profile of a patient with fatal H7N9 infection by massively parallel RNA sequencing.

Bloodstream infections and cytokine dysregulation are associated with high rates of morbidity and mortality among patients with influenza virus H7N9 infection. Here, massively parallel RNA sequencing was used to serially analyse plasma viruses and cytokine transcriptomes of a fatal H7N9-related case at successive times throughout the clinical course of infection. The results showed that acute viraemia with H7N9 virus occurred, and the virus was sensitive to antiviral therapy with oseltamivir. In addition, a lot of genome sequences from Acinetobacter baumannii were detected in blood on day 18 after illness onset when the bacteria were cultured. In parallel, longitudinal mRNA expression patterns of host cytokines associated with infection were analysed. This study illustrated the potential of RNA-sequencing to explore the plasma virome and expression profile of the infected host cytokines simultaneously in infectious disease.